States Put Prior Authorization in Crosshairs, Even Amid Insurer Reforms

More than 30 states last year considered or introduced legislation to reform prior authorization, due in large part to lobbying from physician groups that indicate they are being subject to more PA requirements from insurers, according to a recent analysis from the Georgetown University Center on Health Insurance Reforms (CHIR). While health plans in recent months have touted their reduction in PA mandates, Sabrina Corlette, one of the report’s authors and CHIR’s co-founder, says providers and their staff still are spending numerous hours each week on PA and identify it as a major burden. 

Corlette and her colleagues primarily focused on four states — Arkansas, Illinois, Texas and Washington — that have enacted comprehensive PA reform in the commercial insurance market.